Evaluation of the ear and nose

1. Evaluation of the ear and nose Athletic Trainers

2. EXAMINATION OF THE EAR External and internal

3. SUBJECTIVE ASSESSMENT • EARACHES • OTORRHEA • HEARING LOSS • EXPOSURE TO LOUD NOISE • TINNITUS • VERTIGO • USE OF COTTON SWABS/SELF CARE

4. EIGHT CRITICAL CHARACTERISTICS OF A SYMPTOM • LOCATION • QUALITY • QUANTITY • SETTING • TIMING • FACTORS AGGRAVATING/ALLEVIATING • ASSOCIATED FACTORS

5. INSPECTION/PALPATION • INSPECT EXTERNAL EAR STRUCTURES • AURICLES • TRAGUS • EXTERNAL CANAL • PALPATE EXTERNAL STRUCTURES NOTICE TENDERNESS • TRAGUS, MASTOID, AURICLE

6. OTOSCOPIC EXAM • NOTE CANAL • TYMPANIC MEMBRANE • INTACTNESS OF MEMBRANE • CONE OF LIGHT • STRUCTURES • UMBO • LONG & SHORT PROCESS OF MALLEOUS

8. Left Tympanic Membrane

9. Right Tympanic membrane

10. OTOSCOPIC EXAM • POSITION HEAD TILTED AWAY • PINNA UP & BACK • LARGEST SPECULUM THAT WILL FIT • BRACE HAND ON ZYGOMA OR SKULL • INSERT SLOWLY BEFORE LOOKING THROUGH SPECULUM • AVOID CANAL • ROTATE TO VIEW MEMBRANE

11. HEARING TESTS • WHISPER • RINNE • WEBER • AUDIOMETRIC

12. WEBER FORK ON TOP OF HEAD NORMAL----SOUND HEARD EQUALLY IN BOTH EARS RINNE FORK ON MASTOID BONE, THEN AT OPENING OF EAR CANAL NORMAL--AC=2XBC TUNING FORK TESTS

13. EVALUATING THE WEBER • CONDUCTIVE LOSS • SOUND LATERALIZES TO THE DEFECTIVE EAR • SENSORINEURAL LOSS • SOUND LATERALIZES TO THE BETTER EAR

14. EVALUATING THE RINNE • POSITIVE RINNE • SOUND IS HEARD TWICE AS LONG BY AIR CONDUCTION AS BY BONE CONDUCTION--AC>BC • NEGATIVE RINNE • SOUND IS HEARD LONGER BY BONE CONDUCTION THAN BY AIR CONDUC- TION--AC<BC

15. The Nose

16. External exam • Symmetry • Patency • External appearance

17. Internal • Use otoscope and speculum • Insert only ¼ to ½ inch • Patency/Size of airways • Observe turbinates • Color • size

19. Signs of Trouble • Obvious external deviation • Flow of clear fluid out of nostril(s) • Blood &/or clotted blood from nares